A Nurse's Checklist For Donning and Doffing Procedures

In a continued effort to keep nurses safe when treating patients with Ebola, the Center for Disease Control recently updated their personal protective equipment procedures.

The CDC’s update covers the topic in great detail, including recommended administrative and environmental controls for healthcare facilities, training, and proper storage of equipment, but we’re going to focus specifically on the practice of Donning and Doffing.

Why We Don & Doff

Personal Protective Equipment (PPE) sort of looks like you’re preparing to walk on the moon—your head is covered with a helmet of sorts with a clear panel in the front so you can see and your body is covered, in most cases from head to toe. Funny looks aside, PPE is critical when dealing with Ebola, considering the fact that it’s spread through direct contact. If the virus comes in contact with broken skin or mucous membranes, including the eyes, nose or mouth, a nurse can become infected just like that. If an Ebola patient is on the premises, it’s a safe bet that nurses will be working extremely close to him or her, so PPE is really about keeping nurses safe so they can do their jobs effectively.

Before Using PPE Procedures

Before nurses interact with Ebola patients, it’s important that that she or he goes through extensive training of personal protective equipment procedures.
Donning, the act of putting on protective equipment, and doffing, the act of removing the protective equipment, has to be done in separate, designated areas of the hospital. Nurses need to be able to don and doff without any distractions or interruptions.
Each time it’s done, a trained observer should be watching the process closely to ensure that every precaution is taken.

CDC Recommended Equipment for PPE

PAPR (Powered Air Purifying Respirators) or N95 Respirator- A PAPR has a full face shield headpiece or helmet. It must be used with a disposable hood that covers the shoulders and neck. N95 Respirators are used with a disposable hood and a disposable, single use full face shield.

Single-use (disposable) Fluid-Resistant or Impermeable gown – Extends to at least mid-calf. Coveralls with or without integrated socks can be used.